Advertisement

Liver and Biliary Tract

  • Spiros P. Hiotis
  • Hersch L. Pachter

Abstract

You are asked to see a 32-year-old intensive care unit patient in the medical service who is febrile and lethargic with a history, according to her husband—a selfproclaimed recluse—of shaking chills and who needs evaluation and possible management. With the exception of hospitalization for childbirth (youngest child is 1 year old), the patient has no known medical problems. On physical examination, the patient is jaundice and has right upper quadrant tenderness. There is no rebound tenderness. The patient was recently started on pressors to achieve hemodynamic stability. Pertinent positive laboratory results include an alkaline phosphatase level of 600, a total bilirubin level of 6 (direct −4.5), and a white blood cell count of 15,000. The patient has been receiving full-spectrum antibiotics for 36 hours. Which of the following recommendations should your acute care surgical consultation render?

Keywords

Acute Pancreatitis Common Bile Duct Acute Cholecystitis Transjugular Intrahepatic Portosystemic Shunt Liver Abscess 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Couinaud C. Liver anatomy: portal (and suprahepatic) or biliary segmentation. Dig Surg 1999; 16:459–467.PubMedCrossRefGoogle Scholar
  2. 2.
    Botero AC, Strasberg SM. Division of the left hemiliver in man—segments, sectors, or sections. Liver Transplant Surg 1998; 4:226–231.CrossRefGoogle Scholar
  3. 3.
    Strasberg SM. Terminology of liver anatomy and liver resections: coming to grips with hepatic Babel. J Am Coll Surg 1997; 184:413–434.PubMedGoogle Scholar
  4. 4.
    Jung G, Krahe T, Krug B, Hahn U, Raab M. Delineation of segmental liver anatomy. Comparison of ultrasonography, spiral CT and MR imaging for preoperative localization of focal liver lesions to specific hepatic segments. Acta Radiol 1996; 37:691–695.PubMedCrossRefGoogle Scholar
  5. 5.
    Amitrano L, Guardascione MA, Brancaccio V, Balzano A. Coagulation disorders in liver disease. Semin Liver Dis 2002; 22:83–96.PubMedCrossRefGoogle Scholar
  6. 6.
    Roe PG. Liver function tests in the critically ill patient. Clin Intensive Care 1993; 4:174–182.PubMedGoogle Scholar
  7. 7.
    Moseley RH. Evaluation of abnormal liver function tests. Med Clin North Am 1996; 80:887–906.PubMedGoogle Scholar
  8. 8.
    Lauterburg BH. Assessment of liver function prior to hepatic resection. Swiss Surg 1999; 5:92–96.PubMedCrossRefGoogle Scholar
  9. 9.
    Shaked A, Nunes FA, Olthoff KM, Lucey MR. Assessment of liver function: pre-and peritransplant evaluation. Clin Chem 1997; 43:1539–1545.PubMedGoogle Scholar
  10. 10.
    Blendis L, Wong F. The hyperdynamic circulation in cirrhosis: an overview. Pharmacol Ther 2001; 89:221–231.PubMedCrossRefGoogle Scholar
  11. 11.
    Fenchel S, Fleiter TR, Merkle EM. Multislice helical CT of the abdomen. Eur Radiol 2002; 12(Suppl 2):S5–S10.PubMedCrossRefGoogle Scholar
  12. 12.
    Delgado Millan MA, Deballon PO. Computed tomography, angiography, and endoscopic retrograde cholangiopancreatography in the nonoperative management of hepatic and splenic trauma. World J Surg 2001; 25:1397–1402.PubMedGoogle Scholar
  13. 13.
    Brink JA. Contrast optimization and scan timing for single and multidetector-row computed tomography. J Comput Assist Tomogr 2003; 27(Suppl 1):S3–S8.PubMedGoogle Scholar
  14. 14.
    Mortele KJ, McTavish J, Ros PR. Current techniques of computed tomography. Helical CT, multidetector CT, and 3D reconstruction. Clin Liver Dis 2002; 6:29–52.PubMedCrossRefGoogle Scholar
  15. 15.
    Nelson RC, Spielmann AL. Liver imaging with multidetector helical computed tomography. J Comput Assist Tomogr 2003; 27(Suppl 1):S9–S16.PubMedGoogle Scholar
  16. 16.
    Reddy SI, Grace ND. Liver imaging. A hepatologist’s perspective. Clin Liver Dis 2002; 6:297–310, ix.PubMedCrossRefGoogle Scholar
  17. 17.
    Ros PR, Mortele KJ. Hepatic imaging. An overview. Clin Liver Dis 2002; 6:1–16.PubMedCrossRefGoogle Scholar
  18. 18.
    Vauthey JN, Rousseau DL Jr. Liver imaging. A surgeon’s perspective. Clin Liver Dis 2002; 6:271–295.PubMedCrossRefGoogle Scholar
  19. 19.
    Shankar S, van Sonnenberg E, Silverman SG, Tuncali K. Interventional radiology procedures in the liver. Biopsy, drainage, and ablation. Clin Liver Dis 2002; 6:91–118.PubMedCrossRefGoogle Scholar
  20. 20.
    Huang CJ, Pitt HA, Lipsett PA, et al. Pyogenic hepatic abscess. Changing trends over 42 years. Ann Surg 1996; 223:600–609.PubMedCrossRefGoogle Scholar
  21. 21.
    Pereira FE, Musso C, Castelo JS. Pathology of pyogenic liver abscess in children. Pediatr Dev Pathol 1999; 2:537–543.PubMedCrossRefGoogle Scholar
  22. 22.
    Barakate MS, Stephen MS, Waugh RC, et al. Pyogenic liver abscess: a review of 10 years’ experience in management. Aust N Z J Surg 1999; 69:205–209.PubMedCrossRefGoogle Scholar
  23. 23.
    Moore SW, Millar AJ, Cywes S. Conservative initial treatment for liver abscesses in children. Br J Surg 1994; 81: 872–874.PubMedCrossRefGoogle Scholar
  24. 24.
    Brolin RE, Nosher JL, Leiman S, Lee WS, Greco RS. Percutaneous catheter versus open surgical drainage in the treatment of abdominal abscesses. Am Surg 1984; 50:102–108.PubMedGoogle Scholar
  25. 25.
    Lang EK, Springer RM, Glorioso LW III, et al. Abdominal abscess drainage under radiology guidance: causes of failure. Radiology 1986; 159:329–336.PubMedGoogle Scholar
  26. 26.
    van Sonnenberg E, Wittich GR, Casola G, et al. Percutaneous drainage of infected and noninfected pancreatic pseudocysts: experience in 101 cases. Radiology 1989; 170:757–761.Google Scholar
  27. 27.
    Goletti O, Lippolis PV, Chiarugi M, et al. Percutaneous ultrasound-guided drainage of intra-abdominal abscesses. Br J Surg 1993; 80:336–339.PubMedCrossRefGoogle Scholar
  28. 28.
    Voros D, Gouliamos A, Kotoulas G, Kouloheri D, Saloum G, Kalovidouris A. Percutaneous drainage of intra-abdominal abscesses using large lumen tubes under computed tomographic control. Eur J Surg 1996; 162:895–898.PubMedGoogle Scholar
  29. 29.
    Ch Yu S, Hg Lo R, Kan PS, Metreweli C. Pyogenic liver abscess: treatment with needle aspiration. Clin Radiol 1997; 52:912–916.PubMedCrossRefGoogle Scholar
  30. 30.
    Gerzof SG, Johnson WC, Robbins AH, et al. Expanded criteria for percutaneous abscess drainage. Arch Surg 1985; 120:227–232.PubMedGoogle Scholar
  31. 31.
    Sharma MP, Dasarathy S, Sushma S, Verma N. Long term follow-up of amebic liver abscess: clinical and ultrasound patterns of resolution. Trop Gastroenterol 1995; 16:24–28.PubMedGoogle Scholar
  32. 32.
    Carpenter HA. Bacterial and parasitic cholangitis. Mayo Clin Proc 1998; 73:473–478.PubMedCrossRefGoogle Scholar
  33. 33.
    Sinanan MN. Acute cholangitis. Infect Dis Clin North Am 1992; 6:571–599.PubMedGoogle Scholar
  34. 34.
    Nahrwold DL. Acute cholangitis. Surgery 1992; 112:487–488.PubMedGoogle Scholar
  35. 35.
    Kimmings AN, van Deventer SJ, Rauws EAJ, Huibregtse K, Gouma DJ. Systemic inflammatory response in acute cholangitis and after subsequent treatment. Eur J Surg 2000; 166:700–705.PubMedCrossRefGoogle Scholar
  36. 36.
    Rerknimitr R, Fogel EL, Kalayci C, Esber E, Lehman GA, Sherman S. Microbiology of bile in patients with cholangitis or cholestasis with and without plastic biliary endoprosthesis. Gastrointest Endosc 2002; 56:885–889.PubMedCrossRefGoogle Scholar
  37. 37.
    Sheen-Chen S, Chen W, Eng H, et al. Bacteriology and antimicrobial choice in hepatolithiasis. Am J Infect Control 2000; 28:298–301.PubMedCrossRefGoogle Scholar
  38. 38.
    Karachalios GN, Zografos G, Patrikakos V, Nassopoulou D, Kehagioglou K. Biliary tract infections treated with ciprofloxacin. Infection 1993; 21:262–264.PubMedCrossRefGoogle Scholar
  39. 39.
    Gumaste VV. Antibiotics and cholangitis. Gastroenterology 1995; 109:323–325.PubMedCrossRefGoogle Scholar
  40. 40.
    Sung JJ, Lyon DJ, Suen R, et al. Intravenous ciprofloxacin as treatment for patients with acute suppurative cholangitis: a randomized, controlled clinical trial. J Antimicrob Chemother 1995; 35:855–864.PubMedCrossRefGoogle Scholar
  41. 41.
    Siegel JH, Rodriquez R, Cohen SA, Kasmin FE, Cooperman AM. Endoscopic management of cholangitis: critical review of an alternative technique and report of a large series. Am J Gastroenterol 1994; 89:1142–1146.PubMedGoogle Scholar
  42. 42.
    Lee WJ, Chang KJ, Lee CS, Chen KM. Surgery in cholangitis: bacteriology and choice of antibiotic. Hepatogastroenterology 1992; 39:347–349.PubMedGoogle Scholar
  43. 43.
    Balci NC, Sirvanci M. MR imaging of infective liver lesions. Magn Reson Imaging Clin North Am 2002; 10:121–135, vii.CrossRefGoogle Scholar
  44. 44.
    Barreda R, Ros PR. Diagnostic imaging of liver abscess. Crit Rev Diagn Imaging 1992; 33:29–58.PubMedGoogle Scholar
  45. 45.
    Fujihara T, Nagai Y, Kubo T, Seki S, Satake K. Amebic liver abscess. J Gastroenterol 1996; 31:659–663.PubMedCrossRefGoogle Scholar
  46. 46.
    Hughes MA, Petri WA Jr. Amebic liver abscess. Infect Dis Clin North Am 2000; 14:565–582, viii.PubMedCrossRefGoogle Scholar
  47. 47.
    Sharma MP, Dasarathy S. Amoebic liver abscess. Trop Gastroenterol 1993; 14:3–9.PubMedGoogle Scholar
  48. 48.
    Pedrosa I, Saiz A, Arrazola J, Ferreiros J, Pedrosa CS. Hydatid disease: radiologic and pathologic features and complications. Radiographics 2000; 20:795–817.PubMedGoogle Scholar
  49. 49.
    Gunay K, Taviloglu K, Berber E, Ertekin C. Traumatic rupture of hydatid cysts: a 12-year experience from an endemic region. J Trauma 1999; 46:164–167.PubMedCrossRefGoogle Scholar
  50. 50.
    Bartoloni C, Tricerri A, Guidi L, Gambassi G. The efficacy of chemotherapy with mebendazole in human cystic echinococcosis: long-term follow-up of 52 patients. Ann Trop Med Parasitol 1992; 86:249–256.PubMedGoogle Scholar
  51. 51.
    De Rosa F, Teggi A. Treatment of Echinococcus granulosus hydatid disease with albendazole. Ann Trop Med Parasitol 1990; 84:467–872.PubMedGoogle Scholar
  52. 52.
    Sakai Y. Images in clinical medicine. Emphysematous cholecystitis. N Engl J Med 2003; 348:2329.PubMedCrossRefGoogle Scholar
  53. 53.
    Yusoff IF, Barkun JS, Barkun AN. Diagnosis and management of cholecystitis and cholangitis. Gastroenterol Clin North Am 2003; 32:1145–1168.PubMedCrossRefGoogle Scholar
  54. 54.
    Fayad LM, Holland GA, Bergin D, et al. Functional magnetic resonance cholangiography (fMRC) of the gallbladder and biliary tree with contrast-enhanced magnetic resonance cholangiography. J Magn Reson Imaging 2003; 18:449–460.PubMedCrossRefGoogle Scholar
  55. 55.
    Gore RM, Yaghmai V, Newmark GM, Berlin JW, Miller FH. Imaging benign and malignant disease of the gallbladder. Radiol Clin North Am 2002; 40:1307–1323, vi.PubMedCrossRefGoogle Scholar
  56. 56.
    Johansson M, Thune A, Blomqvist A, Nelvin L, Lundell L. Management of acute cholecystitis in the laparoscopic era: results of a prospective, randomized clinical trial. J Gastrointest Surg 2003; 7:642–645.PubMedCrossRefGoogle Scholar
  57. 57.
    Kitano S, Matsumoto T, Aramaki M, Kawano K. Laparoscopic cholecystectomy for acute cholecystitis. J Hepatobiliary Pancreat Surg 2002; 9:534–537.PubMedCrossRefGoogle Scholar
  58. 58.
    Bhattacharya D, Senapati PS, Hurle R, Ammori BJ. Urgent versus interval laparoscopic cholecystectomy for acute cholecystitis: a comparative study. J Hepatobiliary Pancreat Surg 2002; 9:538–542.PubMedCrossRefGoogle Scholar
  59. 59.
    Papi C, Catarci M, D’Ambrosio L, et al. Timing of cholecystectomy for acute calculous cholecystitis: a metaanalysis. Am J Gastroenterol 2004; 99:147–155.PubMedCrossRefGoogle Scholar
  60. 60.
    Senapati PS, Bhattarcharya D, Harinath G, Ammori BJ. A survey of the timing and approach to the surgical management of cholelithiasis in patients with acute biliary pancreatitis and acute cholecystitis in the UK. Ann R Coll Surg Engl 2003; 85:306–312.PubMedCrossRefGoogle Scholar
  61. 61.
    Serralta AS, Bueno JL, Planells MR, Rodero DR. Prospective evaluation of emergency versus delayed laparoscopic cholecystectomy for early cholecystitis. Surg Laparosc Endosc Percutan Tech 2003; 13:71–75.PubMedCrossRefGoogle Scholar
  62. 62.
    Byrne MF, Suhocki P, Mitchell RM, et al. Percutaneous cholecystostomy in patients with acute cholecystitis: experience of 45 patients at a US referral center. J Am Coll Surg 2003; 197:206–211.PubMedCrossRefGoogle Scholar
  63. 63.
    Haroun A, Hadidi A, Tarawneh E, Shennak M. Magnetic resonance cholangiopancreatography in patients with upper abdominal pain: a prospective study. Hepatogastroenterology 2003; 50:1236–1241.PubMedGoogle Scholar
  64. 64.
    Raraty MG, Finch M, Neoptolemos JP. Acute cholangitis and pancreatitis secondary to common duct stones: management update. World J Surg 1998; 22:1155–1161.PubMedCrossRefGoogle Scholar
  65. 65.
    Himal HS. Common bile duct stones: the role of preoperative, intraoperative, and postoperative ERCP. Semin Laparosc Surg 2000; 7:237–245.PubMedCrossRefGoogle Scholar
  66. 66.
    Hammarstrom LE, Andersson R, Stridbeck H, Ihse I. Influence of bile duct stones on patient features and effect of endoscopic sphincterotomy on early outcome of edematous gallstone pancreatitis. World J Surg 1999; 23:12–17.PubMedCrossRefGoogle Scholar
  67. 67.
    Yao LQ, Zhang YQ, Zhou PH, Gao WD, He GJ, Xu MD. Endoscopic sphincterotomy or papillary balloon dilatation for choledocholithiasis. Hepatobiliary Pancreat Dis Int 2002; 1:101–105.PubMedGoogle Scholar
  68. 68.
    Brooks AD, Mallis MJ, Brennan MF, Conlon KC. The value of laparoscopy in the management of ampullary, duodenal, and distal bile duct tumors. J Gastrointest Surg 2002; 6:139–146.PubMedCrossRefGoogle Scholar
  69. 69.
    Cohen ME, Slezak L, Wells CK, Andersen DK, Topazian M. Prediction of bile duct stones and complications in gallstone pancreatitis using early laboratory trends. Am J Gastroenterol 2001; 96:3305–3311.PubMedCrossRefGoogle Scholar
  70. 70.
    Meek K, de Virgilio C, Murrell Z, et al. Correlation between admission laboratory values, early abdominal computed tomography, and severe complications of gallstone pancreatitis. Am J Surg 2000; 180:556–560.PubMedCrossRefGoogle Scholar
  71. 71.
    Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology 1990; 174:331–336.PubMedGoogle Scholar
  72. 72.
    Balthazar EJ. Complications of acute pancreatitis: clinical and CT evaluation. Radiol Clin North Am 2002; 40:1211–1227.PubMedCrossRefGoogle Scholar
  73. 73.
    Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology 2002; 223:603–613.PubMedCrossRefGoogle Scholar
  74. 74.
    Pisters PW, Ranson JH. Nutritional support for acute pancreatitis. Surg Gynecol Obstet 1992; 175:275–284.PubMedGoogle Scholar
  75. 75.
    Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974; 139:69–81.PubMedGoogle Scholar
  76. 76.
    Barkun AN. Early endoscopic management of acute gallstone pancreatitis—an evidence-based review. J Gastrointest Surg 2001; 5:243–250.PubMedCrossRefGoogle Scholar
  77. 77.
    Kaw M, Al-Antably Y, Kaw P. Management of gallstone pancreatitis: cholecystectomy or ERCP and endoscopic sphincterotomy. Gastrointest Endosc 2002; 56:61–65.PubMedCrossRefGoogle Scholar
  78. 78.
    Ricci F, Castaldini G, de Manzoni G, et al. Treatment of gallstone pancreatitis: six-year experience in a single center. World J Surg 2002; 26:85–90.PubMedCrossRefGoogle Scholar
  79. 79.
    Lobo DN, Jobling JC, Balfour TW. Gallstone ileus: diagnostic pitfalls and therapeutic successes. J Clin Gastroenterol 2000; 30:72–76.PubMedCrossRefGoogle Scholar
  80. 80.
    Doko M, Zovak M, Kopljar M, Glavan E, Ljubicic N, Hochstadter H. Comparison of surgical treatments of gallstone ileus: preliminary report. World J Surg 2003; 27:400–404.PubMedCrossRefGoogle Scholar
  81. 81.
    Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am Surg 1994; 60:441–446.PubMedGoogle Scholar
  82. 82.
    Zuegel N, Hehl A, Lindemann F, Witte J. Advantages of one-stage repair in case of gallstone ileus. Hepatogastroenterology 1997; 44:59–62.PubMedGoogle Scholar
  83. 83.
    Suarez-Penaranda JM, de la Calle MC, Rodriguez-Calvo MS, Munoz JI, Concheiro L. Rupture of liver cell adenoma with fatal massive hemoperitoneum resulting from minor road accident. Am J Forensic Med Pathol 2001; 22:275–277.PubMedCrossRefGoogle Scholar
  84. 84.
    Hotokezaka M, Kojima M, Nakamura K, et al. Traumatic rupture of hepatic hemangioma. J Clin Gastroenterol 1996; 23:69–71.PubMedCrossRefGoogle Scholar
  85. 85.
    Yoshida H, Onda M, Tajiri T, et al. Treatment of spontaneous ruptured hepatocellular carcinoma. Hepatogastroenterology 1999; 46:2451–2453.PubMedGoogle Scholar
  86. 86.
    Sonoda T, Kanematsu T, Takenaka K, Sugimachi K. Ruptured hepatocellular carcinoma evokes risk of implanted metastases. J Surg Oncol 1989; 41:183–186.PubMedCrossRefGoogle Scholar
  87. 87.
    Vergara V, Muratore A, Bouzari H, et al. Spontaneous rupture of hepatocellular carcinoma: surgical resection and long-term survival. Eur J Surg Oncol 2000; 26:770–772.PubMedCrossRefGoogle Scholar
  88. 88.
    Sato Y, Fujiwara K, Furui S, et al. Benefit of transcatheter arterial embolization for ruptured hepatocellular carcinoma complicating liver cirrhosis. Gastroenterology 1985; 89:157–159.PubMedGoogle Scholar
  89. 89.
    Shimada R, Imamura H, Makuuchi M, et al. Staged hepatectomy after emergency transcatheter arterial embolization for ruptured hepatocellular carcinoma. Surgery 1998; 124:526–535.PubMedGoogle Scholar
  90. 90.
    Sarmiento JM, Sarr MG. Necrotic infected liver metastasis from colon cancer. Surgery 2002; 132:110–111.PubMedCrossRefGoogle Scholar
  91. 91.
    Huang SF, Ko CW, Chang CS, Chen GH. Liver abscess formation after transarterial chemoembolization for malignant hepatic tumor. Hepatogastroenterology 2003; 50:1115–1118.PubMedGoogle Scholar
  92. 92.
    Kim W, Clark TW, Baum RA, Soulen MC. Risk factors for liver abscess formation after hepatic chemoembolization. J Vasc Intervent Radiol 2001; 12:965–968.CrossRefGoogle Scholar
  93. 93.
    Song SY, Chung JW, Han JK, et al. Liver abscess after transcatheter oily chemoembolization for hepatic tumors: incidence, predisposing factors, and clinical outcome. J Vasc Intervent Radiol 2001; 12:313–320.CrossRefGoogle Scholar
  94. 94.
    Yeh TS, Jan YY, Tseng JH, et al. Malignant perihilar biliary obstruction: magnetic resonance cholangiopancreatographic findings. Am J Gastroenterol 2000; 95:432–440.PubMedCrossRefGoogle Scholar
  95. 95.
    Georgopoulos SK, Schwartz LH, Jarnagin WR, et al. Comparison of magnetic resonance and endoscopic retrograde cholangiopancreatography in malignant pancreaticobiliary obstruction. Arch Surg 1999; 134:1002–1007.PubMedCrossRefGoogle Scholar
  96. 96.
    Marcus SG, Dobryansky M, Shamamian P, et al. Endoscopic biliary drainage before pancreaticoduodenectomy for periampullary malignancies. J Clin Gastroenterol 1998; 26:125–129.PubMedCrossRefGoogle Scholar
  97. 97.
    Lai EC, Lo CM, Liu CL. Endoscopic stenting for malignant biliary obstruction. World J Surg 2001; 25:1289–1295.PubMedCrossRefGoogle Scholar
  98. 98.
    Espat NJ, Brennan MF, Conlon KC. Patients with laparoscopically staged unresectable pancreatic adenocarcinoma do not require subsequent surgical biliary or gastric bypass. J Am Coll Surg 1999; 188:649–657.PubMedCrossRefGoogle Scholar
  99. 99.
    Lillemoe KD, Cameron JL, Hardacre JM, et al. Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? A prospective randomized trial. Ann Surg 1999; 230:322–330.PubMedCrossRefGoogle Scholar
  100. 100.
    Sohn TA, Lillemoe KD. Surgical palliation of pancreatic cancer. Adv Surg 2000; 34:249–271.PubMedGoogle Scholar
  101. 101.
    MacMathuna P, Vlavianos P, Westaby D, Williams R. Pathophysiology of portal hypertension. Dig Dis 1992; 10(Suppl 1):3–15.PubMedCrossRefGoogle Scholar
  102. 102.
    McCormick PA, Jenkins SA, McIntyre N, Burroughs AK. Why portal hypertensive varices bleed and bleed: a hypothesis. Gut 1995; 36:100–103.PubMedCrossRefGoogle Scholar
  103. 103.
    Hoefs JC, Jonas GM, Sarfeh IJ. Diagnosis and hemodynamic assessment of portal hypertension. Surg Clin North Am 1990; 70:267–289.PubMedGoogle Scholar
  104. 104.
    Celinska-Cedro D, Teisseyre M, Woynarowski M, Socha P, Socha J, Ryzko J. Endoscopic ligation of esophageal varices for prophylaxis of first bleeding in children and adolescents with portal hypertension: preliminary results of a prospective study. J Pediatr Surg 2003; 38:1008–1011.PubMedCrossRefGoogle Scholar
  105. 105.
    Yoshikawa I, Murata I, Nakano S, Otsuki M. Effects of endoscopic variceal ligation on portal hypertensive gastropathy and gastric mucosal blood flow. Am J Gastroenterol 1998; 93:71–74.PubMedCrossRefGoogle Scholar
  106. 106.
    Teres J, Cecilia A, Bordas JM, Rimola A, Bru C, Rodes J. Esophageal tamponade for bleeding varices. Controlled trial between the Sengstaken-Blakemore tube and the Linton-Nachlas tube. Gastroenterology 1978; 75:566–569.PubMedGoogle Scholar
  107. 107.
    McCormick PA, Burroughs AK, McIntyre N. How to insert a Sengstaken-Blakemore tube. Br J Hosp Med 1990; 43: 274–277.PubMedGoogle Scholar
  108. 108.
    Sokucu S, Suoglu OD, Elkabes B, Saner G. Long-term outcome after sclerotherapy with or without a betablocker for variceal bleeding in children. Pediatr Int 2003; 45:388–394.PubMedCrossRefGoogle Scholar
  109. 109.
    Schiedermaier P, Koch L, Stoffel-Wagner B, Layer G, Sauerbruch T. Effect of propranolol and depot lanreotide SR on postprandial and circadian portal haemodynamics in cirrhosis. Aliment Pharmacol Ther 2003; 18:777–784.PubMedCrossRefGoogle Scholar
  110. 110.
    Gusberg RJ. Distal splenorenal shunt—premise, perspective, practice. Dig Dis 1992; 10(Suppl 1): 84–93.PubMedCrossRefGoogle Scholar
  111. 111.
    Rosemurgy AS 2nd, Bloomston M, Zervos EE, et al. Transjugular intrahepatic portosystemic shunt versus Hgraft portacaval shunt in the management of bleeding varices: a cost-benefit analysis. Surgery 1997; 122:794–800.PubMedCrossRefGoogle Scholar
  112. 112.
    Serafini FM, Zwiebel B, Black TJ, Carey LC, Rosemurgy AS 2nd. Transjugular intrahepatic portasystemic stent shunt in the treatment of variceal bleeding in hepatocellular cancer. Dig Dis Sci 1997; 42:59–65.PubMedCrossRefGoogle Scholar
  113. 113.
    Rosemurgy AS, Serafini FM, Zweibel BR, et al. Transjugular intrahepatic portosystemic shunt vs. smalldiameter prosthetic H-graft portacaval shunt: extended follow-up of an expanded randomized prospective trial. J Gastrointest Surg 2000; 4:589–97.PubMedCrossRefGoogle Scholar
  114. 114.
    McCormick PA, Dick R, Chin J, et al. Transjugular intrahepatic portosystemic stent-shunt. Br J Hosp Med 1993; 49:791–797.PubMedGoogle Scholar
  115. 115.
    Boyer TD. Transjugular intrahepatic portosystemic shunt: current status. Gastroenterology 2003; 124:1700–1710.PubMedCrossRefGoogle Scholar
  116. 116.
    Pachter HL, Hofstetter SR. The current status of nonoperative management of adult blunt hepatic injuries. Am J Surg 1995; 169:442–454.PubMedCrossRefGoogle Scholar
  117. 117.
    Pachter HL. Is a conservative approach justified in penetrating liver injury? HPB Surg 1995; 8:205–208.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Spiros P. Hiotis
    • 1
  • Hersch L. Pachter
    • 1
  1. 1.Department of SurgeryNew York University School of MedicineNew YorkUSA

Personalised recommendations